睫状环及前玻璃体切除治疗睫状环阻塞性青光眼

Cyclectomy combined with anterior vitrectomy for ciliary block glaucoma

目的 探讨睫状环切除联合前部玻璃体切除治疗睫状环阻塞性青光眼的效果。方法 5例 (6眼 )因抗青光眼手术及白内障超声乳化术而诱发的睫状环阻塞性青光眼 ,在以角膜缘为基底 4mm× 5mm的巩膜瓣下 ,切除 2 5mm× 3mm的巩膜壁 ,电凝巩膜床及暴露的睫状体 ,切除电凝后的睫状体。显微镜直视下 ,由表及里地切除前部玻璃体。使玻璃体腔经晶状体赤道部与后房及前房贯通。随访 3月～2年。结果 4眼眼压得到控制 (1 2～ 2 1mmHg) (1mmHg =0 1 33kPa) ;1眼眼压 8～ 1 0mmHg ;另 1眼波动在 2 4～2 8mmHg之间 ,使用噻吗心胺滴眼液能控制在 2 2mmHg以下。 5眼视力增加 ,最高达0 8,1眼出现并发白内障。结论 本手术既能有效控制眼压 ,又能保留透明晶状体 。

To study the effects of cyclectomy combined with a nterior witrectomy on ciliary block glaucoma.Methods The surgeries,including dissecting partial lamellar scl eral flap,partial lamellar sclerocyclectomy and anterior vitrectomy,were perform ed in 6 eyes (5 cases)with ciliary block glaucoma after trabeculectomy or catar act phacoemulsification.Results During follow-up period of 3 month to 2 years,the post operative intraocular pressure was controlled between 10 to 21 mmHg(1mmHg=0.133 kPa) in 4 eyes;between 8 to 10 mmHg in one eyes;and between 24 to 28 mmHg in 1 eye,in which intraocular pressure was decreased to 22 mmHg by timolol ey e drop.Visual acuity was increased in 5 eyes.The complication included cataract wa s in only one eye. Conclusion The combined surgery has advantage of decreasing intraocular pressure effectively,remaining transparent lens and resuming visual acuity.